Learning from the Ebola Response in cities: Communication and engagement

This paper explores the urban-specific challenges of the Ebola Virus Disease (EVD) epidemic in West Africa, focusing specifically on community engagement. In doing so, it identifies learning to take forward into future urban public health crises. Key points made in the paper are as follows:

• Communication and engagement are broad terms to describe a variety of ways in which crisis affected people can be involved in a response.

• All of the countries affected by EVD have complex social and power structures and diverse cultures and populations. These populations exhibit varying degrees of capacity to respond to an epidemic.

• Humanitarians struggled to respond to the scale of the challenge during the EVD response. In particular, the atomised nature of community and diversity among stakeholders made it difficult for responders to use traditional approaches to communication and engagement.

• The range of stakeholders in urban environments provides opportunities for communication and engagement as well as challenges. Unfortunately, many opportunities to effectively engage communities and bring stakeholders together were missed during the EVD outbreak.

• Humanitarians used a variety of communication and engagement approaches during the EVD response, including social media chat groups, community radio and door-to-door canvassing.
Communication was particularly challenging owing to restrictions on movement and public gatherings.

• Practical, relevant messaging is critical in urban public health crises. Many messages during the EVD response were clinical, negative and confusing.

• A history of mistrust between the population and authorities further complicated response and furthered new fears. It took time for humanitarians to understand these dynamics and to know how to respond to them.

• The nature of urban communities and lack of social cohesion made it harder to get people to work together within the response. Though there were examples of community self-mobilisation, often these efforts did not receive sufficient support.